Rickettsial pathogens and arthropod vectors of medical and veterinary significance on Kwajalein Atoll and Wake Island

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1 Micronesica 43(1): , 2012 Rickettsial pathogens and arthropod vectors of medical and veterinary significance on Kwajalein Atoll and Wake Island Will K. Reeves USAF School of Aerospace Medicine (USAFSAM/PHR) th Street, Wright-Patterson AFB, OH Curtis M. Utter US Army, PHCR-Pacific, Unit 45006, MCHB-AJ-TLD, APO, AP Lance Durden Department of Biology, Georgia Southern University, Statesboro, GA , U.S.A. Abstract Modern surveys of ectoparasites and potential vector-borne pathogens in the Republic of the Marshall Islands and Wake Island are poorly documented. We report on field surveys of ectoparasites from 2010 with collections from dogs, cats, and rats. Five ectoparasites were identified: the cat flea Ctenocephalides felis, a sucking louse Hoplopleura pacifica, the mites Laelaps nuttalli and Radfordia ensifera, and the brown dog tick Rhipicephalus sanguineus. Ectoparasites were screened for rickettsial pathogens. DNA from Anaplasma platys, a Coxiella symbiont of Rhipicephalus sanguineus, and a Rickettsia sp. were identified by PCR and DNA sequencing from ticks and fleas on Kwajalein Atoll. An unidentified spotted fever group Rickettsia was detected in a pool of Laelaps nuttalli and Hoplopleura pacifica from Wake Island. The records of Hoplopleura pacifica, Laelaps nuttalli, and Radfordia ensifera and the pathogens are new for Kwajalein Atoll and Wake Island. Introduction Kwajalein Atoll in the Republic of the Marshall Islands houses the U.S. Army Kwajalein Atoll/Regan Test Site, which is inhabited by over 1,000 civilians, contractors, active duty military personnel and their families. Kwajalein Atoll has been occupied by the US military since Kwajalein Island, the largest island in the atoll, measures over 3.1 km 2 with an average elevation of 1.8 m above sea level. It is tropical, situated near the equator at 8º43' N, 167º43' E, and receives over 25 cm of rain a year. Wake Island is an atoll and part of the unincorporated territories of the USA. Wake Island is located further north at approximately 19º18'N, 166º38' E. The island is over 3.3 km 2 with a similar elevation to that of Kwajalein. There are no native human populations on Wake Island but up to several hundred military affiliated personnel work on the island. There is no natural standing or free flowing fresh water on either atoll.

2 Report Documentation Page Form Approved OMB No Public reporting burden for the collection of information is estimated to average 1 hour per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to Washington Headquarters Services, Directorate for Information Operations and Reports, 1215 Jefferson Davis Highway, Suite 1204, Arlington VA Respondents should be aware that notwithstanding any other provision of law, no person shall be subject to a penalty for failing to comply with a collection of information if it does not display a currently valid OMB control number. 1. REPORT DATE REPORT TYPE 3. DATES COVERED to TITLE AND SUBTITLE Rickettsial pathogens and arthropod vectors of medical and veterinary significance on Kwajalein Atoll and Wake Island 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) 5d. PROJECT NUMBER 5e. TASK NUMBER 5f. WORK UNIT NUMBER 7. PERFORMING ORGANIZATION NAME(S) AND ADDRESS(ES) USAF School of Aerospace Medicine (USAFSAM/PHR),2947 5th Street,Wright-Patterson AFB,OH, PERFORMING ORGANIZATION REPORT NUMBER 9. SPONSORING/MONITORING AGENCY NAME(S) AND ADDRESS(ES) 10. SPONSOR/MONITOR S ACRONYM(S) 12. DISTRIBUTION/AVAILABILITY STATEMENT Approved for public release; distribution unlimited 13. SUPPLEMENTARY NOTES 11. SPONSOR/MONITOR S REPORT NUMBER(S) 14. ABSTRACT Modern surveys of ectoparasites and potential vector-borne pathogens in the Republic of the Marshall Islands and Wake Island are poorly documented. We report on field surveys of ectoparasites from 2010 with collections from dogs, cats, and rats. Five ectoparasites were identified: the cat flea Ctenocephalides felis, a sucking louse Hoplopleura pacifica, the mites Laelaps nuttalli and Radfordia ensifera, and the brown dog tick Rhipicephalus sanguineus. Ectoparasites were screened for rickettsial pathogens. DNA from Anaplasma platys, a Coxiella symbiont of Rhipicephalus sanguineus, and a Rickettsia sp. were identified by PCR and DNA sequencing from ticks and fleas on Kwajalein Atoll. An unidentified spotted fever group Rickettsia was detected in a pool of Laelaps nuttalli and Hoplopleura pacifica from Wake Island. The records of Hoplopleura pacifica, Laelaps nuttalli, and Radfordia ensifera and the pathogens are new for Kwajalein Atoll and Wake Island. 15. SUBJECT TERMS 16. SECURITY CLASSIFICATION OF: 17. LIMITATION OF ABSTRACT a. REPORT unclassified b. ABSTRACT unclassified c. THIS PAGE unclassified Same as Report (SAR) 18. NUMBER OF PAGES 7 19a. NAME OF RESPONSIBLE PERSON Standard Form 298 (Rev. 8-98) Prescribed by ANSI Std Z39-18

3 108 Micronesica 43(1), 2012 Surveys of vectors of human and animals diseases were conducted throughout the Pacific after World War II, but very little continued research has been focused on the smaller islands or island nations of the Pacific. Vector-borne diseases have emerged on several occasions on Kwajalein or the neighboring atolls of the Republic of the Marshall Islands. For example, an outbreak of dengue on Kwajalein in 1974 spread throughout the Pacific (WHO 1975). The arthropod fauna of Kwajalein Atoll was reviewed by Sugerman (1972, 1979). Medically significant arthropods included three mosquitoes, Aedes aegypti (L.), Aedes marshallensis Stone & Bohart, and Culex quinquefasciatus Say. In addition, the brown dog tick, Rhipicephalus sanguineus (Latreille), and the cat flea, Ctenocepalides felis (Bouché), were reported from the atoll (Sugerman 1972). No other ectoparasites of humans or animals were reported. A scorpion, Isometrus maculatus (De Geer), was also reported from buildings on the island (Sugerman 1972). Wake Island has historically been free of fleas and most biting arthropods. However, Ae. aegypti was established on Wake Island (Rosen et al. 1948). There are no current reports of biting arthropods or ectoparasites on Wake Island. Large populations of Rattus spp. are known from Kwajalein Atoll and Wake Island (Spennemann 1997), but their ectoparasites are largely undocumented. Materials and Methods We conducted a field survey of ectoparasites that are potential vectors of pathogens of medical and veterinary importance on Kwajalein Atoll from July In addition, we spoke with the veterinary clinic staff on Kwajalein Atoll about historic records of parasites, pathogens, ticks, and fleas. Vectorborne pathogens and parasites were rarely documented at the clinic, but local animals on Ebeye Island (Kwajalein Atoll) were suspected of harboring significant tick populations. A walking survey of Ebeye Island revealed numerous tick infested local dogs. Ticks were removed from 2 local dogs with the owner s permission and stored in 95% ethanol. Adult fleas were collected from pets on Roi Namur Island (Kwajalein Atoll) by the veterinary staff and shipped to our laboratory. Both Kwajalein Atoll and Wake Island have rodent infestations. Rats are routinely trapped by pest control personnel. We examined a freshly killed rat from the housing area on Kwajalein Island. The terminal 1 cm of the tail was clipped off and stored in 95% ethanol. The remainder of the rat was vigorously washed in 35% ethanol for approximately 1 min and carefully examined. All ectoparasites visible on the rat or in the ethanol wash were collected and preserved in 95% ethanol. In addition >100 rodents from Wake Island killed during routine activities in June 2010 were examined for ectoparasites by the local environmental officer. All ectoparasites and the rodent tails from Wake Island were preserved in RNAlater (Qiagen) and shipped to our laboratory for further study. Arthropods were identified using keys for Micronesian species (Kohls 1957, Hopkins 1961, Wilson 1967, 1972a,b) or compared to reference specimens. Representative voucher specimens of each species were submitted to the Georgia

4 Reeves et al.: Rickettsial pathogens in Kwajalein and Wake 109 Southern University Ectoparasite Collection, the US National Tick Collection, or the arthropod collection at the Public Health Command Region - Pacific. Nucleic acids were extracted from arthropods and rodents. Arthropods and rat tails were washed prior to DNA extraction by rinsing in distilled water for 30 seconds. Total DNA was extracted with a DNeasy Blood & Tissue Kit (Qiagen, Valencia, California) and resuspended in 10% tris-hcl. DNA was screened for Anaplasma, Babesia, Bartonella, Coxiella burnetii, Ehrlichia, Hepatozoon canis, and Rickettsia spp. using real time PCR protocols described by Loftis et al (2006a) or Kledmanee et al. (2009). Positive samples were further characterized by traditional PCR and DNA sequencing. The 16S rrna gene was amplified from Anaplasma/Ehrlichia positive samples using the primer pairs EC12A and HE3 and RickF1 and RickR4 (Reeves 2005, Reeves et al. 2006). We amplified DNA from the 17 kd antigen gene of samples positive for Rickettsia using Primer-1 and Primer-2 as described by Webb et al. (1990) or by pairing Primer-1 and Primer-2 with the real time PCR primers to amplify smaller fragments. Controls for each assay included distilled water as a negative control and synthetic DNA oligonucleotides that corresponded to the primers and probe but have unique sequences as a positive control. The synthetic oligonucleotides can be differentiated from real agents by DNA sequencing. PCR products were separated by electrophoresis on 4% agarose gels and visualized under ultraviolet light with ethidium bromide. Products were purified with a QIAquick PCR Purification Kit (Qiagen, Valencia, California). Sequencing reactions were performed with a BigDye Terminator v3.1 Cycle Sequencing Kit (Applied Biosystems, Foster City, California) using PCR primers, and excess dye was removed by ethanol precipitation. Sequences were determined using an ABI 3700 capillary sequencer (Applied Biosystems, Foster City, California), aligned and assembled with Chromas Lite 2.01 (Technelysium, Australia) and ClustalW (Kyoto University Bioinformatics Center, Japan), and compared to sequences in GenBank using the BLAST 2.0 program (NCBI, Bethesda, Maryland). DNA sequences from the 16S rrna gene of a novel Coxiella sp. were deposited in Gen- Bank (Accession # HQ116458) as was the 17kD antigenic gene sequence from a Rickettsia from Wake Island (Accession # HQ322623). Results The following five species of arthropods of medical or veterinary importance were collected during the survey. Arachnida, Acari Ixodidae, Rhipicephalus sanguineus (brown dog tick), (3 males, 4 females), from dogs, Kwajalein Atoll (Ebeye Island), 21 July Laelapidae, Laelaps nuttalli Hirst, (1 female) from Rattus rattus, Kwajalein Atoll (Kwajalein Island), 20 July 2010; Laelaps nuttalli (27 females) from Rattus exulans, Wake Island, June Myobiidae, Radfordia ensifera (Poppe) (1 female) from Rattus sp., Wake Island, June 2010.

5 110 Micronesica 43(1), 2012 Insecta Phthiraptera, Hoplopleuridae, Hoplopleura pacifica Ewing, (2 males, 4 females), from Rattus exulans, Wake Island, June Siphonaptera, Pulicidae, Ctenocephalides felis, (cat flea) (3 males), from cats on Kwajalein Atoll (Roi Namur Island), 3 September A single R. sanguineus from Kwajalein Atoll (Ebeye Island) tested positive for Anaplasma/Ehrlichia by real time PCR. Two fragments of the 16S rrna gene were amplified from that sample using independent PCR protocols. A 730 bp fragment of the 16S rrna gene amplified with the EC12A/HE3 primer pair matched that of Anaplasma platys (GenBank Accession FJ686112). A 1140 bp fragment of 16S rrna was amplified using the Rick1F/Rick4R primer pair and was a 98% match for the Coxiella symbiont of R. sanguineus (GenBank Accession D84559). One C. felis from Kwajalein Atoll (Roi Namur Island) tested positive for a spotted fever group Rickettsia. The 390 bp DNA sequence for the 17kD antigenic gene was 100% identical to Rickettsia sp. cf1and5 and other Rickettsia from fleas (GenBank Accessions AY953286, DQ166937). There are other identical DNA sequences in GenBank from uncultured Rickettsia detected in fleas. A pool of 27 L. nuttalli and 2 H. pacifica from Wake Island tested positive by real time PCR for Rickettsia in duplicate assays. However, the traditional PCR primers did not amplify enough DNA to sequence. Nested PCR with the real time PCR primers allowed amplification of a 76 bp fragment of the 17kD antigenic gene. The fragment was a 94% match for the 17 kd antigenic gene of Rickettsia conorii str. Malish 7 (complete genome GenBank Accession # AE006914) and a 100% match with the predicted protein sequence of Rickettsia heilongjiangensis (GenBank Accession # BAJ09683). All other assays were negative. Discussion Rhipicephalus sanguineus and C. felis were previously reported from Kwajalein Atoll (Sugerman 1972). US Army veterinary clinic personnel regularly examine animals and reported no populations established on Kwajalein Island. However, dogs on Ebeye and Roi Namur Islands are infested. Most of the local workers take the ferry between Ebeye and Kwajalein daily creating an avenue for introducing ectoparasites. Both C. felis and R sanguineus are vectors of rickettsial and parasitic agents to humans and domestic animals. Ctenocephalides felis is primarily an ectoparasite of medium sized mammals including cats and dogs; however, it will feed on humans and can transmit a wide range of pathogens. Rickettsia sp. cf 1 and 5 or related agents with identical gene sequences were previously reported from C. felis and other fleas in the USA, Asia, and Africa (Loftis et al. 2006b, Reeves et al. 2005). This Rickettsia is of unknown pathogenicity but some assays fail to differentiate it from Rickettsia felis (Reeves et al. 2005). Unlike most ticks, R. sanguineus, can survive and breed successfully indoors. Dogs are the primary host for this tick, but it can feed on humans. It is the primary vector of Rickettsia conori, the agent of Mediterranean spotted fever, in Europe and

6 Reeves et al.: Rickettsial pathogens in Kwajalein and Wake 111 Asia (e.g. Psaroulaki et al. 2003). Rhipicephalus sanguineus is a vector of canine ehrlichiosis, anaplasmosis, babesiosis, and hepatozoonosis (Shaw et al. 2001). The detection of A. platys, an agent of canine cyclic thrombocytopenia (Shaw et al. 2001), in a tick from Ebeye indicates the canine disease is circulating on Kwajalein Atoll. Anaplasma platys, infects dog platelets and often co-infects dogs along with Ehrlichia canis. Symptoms of canine cyclic thrombocytopenia can range from asymptomatic to a fatal hemorrhagic disease. Two species of ectoparasitic mites L. nuttalli and R. ensifera and a louse H. pacifica were collected from rats. All three species are among the most widespread ectoparasites of peridomestic rats throughout much of the world. Traub et al. (1978) implicated H. pacifica as a vector of Rickettsia typhi, the agent of murine typhus. Neither L. nuttalli nor R. ensifera have been implicated as vectors of R. typhi. The DNA in the ectoparasites was poorly preserved and partially degraded, possibly related to their storage in RNAlater. However, the detection of a spotted fever group Rickettsia from the combined pool of L. nuttalli and H. pacifica from Wake Island indicates that a Rickettsia is present there. This Rickettsia might be transmitted by the ectoparasites but they could have acquired it in a blood meal or it could be an endosymbiont. Other potential vectors should be examined including bird ticks, fleas, other mites, or lice. A longer DNA sequence or a live isolate could determine the species present. The threat to human health is unknown. Kwajalein Atoll and Wake Island support large populations of Rattus spp. Large scale surveillance of rats for ectoparasites and rodent-borne disease has not been conducted. Overall the arthropod vectors on Kwajalein Atoll and Wake Island have apparently changed little since the surveys by Sugarmann (1972, 1979). However, we have demonstrated that some ectoparasites harbor rickettsial agents on Kwajalein Atoll and Wake Island. They could transmit these agents to humans or domestic animals but further study is needed to assess the risk of transmission. Our survey is preliminary and a larger survey of ectoparasites is needed to fully characterize the agents present on Wake Island or Kwajalein Atoll. Acknowledgements We thank Dominic Leffer and the staff at the Kwajalein Atoll/Regan Test Site for their assistance with collections and access to field sites. Funding for this project was partially provided by the Global Emerging Infections Surveillance and Response System of the Armed Forces Health Surveillance Center. The use of trade names in this document does not constitute an official endorsement or approval of the use of such commercial hardware or software. Do not cite this document for advertisement. Distribution Statement A: Approved for public release; distribution is unlimited. References Hopkins, G. H. E Siphonaptera. Insects of Micronesia 14: Kledmanee, K., S. Suwanpakdee, S. Krajangwong, J., Chatsiriwech, P. Suksai, P. Suwannachat, L. Sariya, R. Buddhirongawatr, P. Charoonrut, & K. Chaichoun.

7 112 Micronesica 43(1), Development of multiplex polymerase chain reaction for detection of Ehrlichia canis, Babesia spp and Hepatozoon canis in canine blood. Southeast Asian Journal of Tropical Medicine and Public Health 1: Kohls, G. M Ixodoidea. Insects of Micronesia 3: Loftis, A. D., W. K. Reeves, D. E. Szumlas, M. M. Abbassy, I. M. Helmy, J. R. Moriarity, & G. A. Dasch. 2006a. Rickettsial agents in Egyptian ticks collected from domestic animals. Experimental and Applied Acarology 40: Loftis, A. D., W. K. Reeves, D. E. Szumlas, M. M. Abbassy, I. M. Helmy, J. R. Moriarity, & G. A. Dasch. 2006b. Surveillance of Egyptian fleas for agents of public health significance: Anaplasma, Bartonella, Coxiella, Ehrlichia, Rickettsia, and Yersinia pestis. American Journal of Tropical Medicine and Hygiene 75: Psaroulaki, A., I. Spyridaki A. Ioannidis, T. Babalis, A. Gikas & Y. Tselentis First isolation and identification of Rickettsia conorii from ticks collected in the region of Fokida in central Greece. Clinical Microbiology 41: Reeves, W. K., M. P. Nelder, & J. A. Korecki Bartonella and Rickettsia in fleas and lice from mammals in South Carolina, USA. Journal of Vector Ecology 30: Reeves W. K Molecular genetic evidence for a novel bacterial endosymbiont of Icosta americana (Diptera: Hippoboscidae). Entomological News 116: Reeves, W. K., L. A. Durden, & G. A. Dasch A spotted fever group Rickettsia from an exotic tick species, Amblyomma exornatum Koch (Acari: Ixodidae), in a reptile breeding facility in the USA. Journal of Medical Entomology 43: Rosen, L., W. C. Reeves, & T. Aarons Aedes aegypti on Wake Island. Proceedings of the Hawaiian Entomological Society 13: Shaw E. S., J. D. Michael, R. J. Birtles, & B. B. Edward Tickborne infectious diseases of dogs. Trends in Parasitology 1: Spennemann, D. H. R Distribution of rat species (Rattus spp.) on the atolls of the Marshall Islands: past and present dispersal. Atoll Research Bulletin 446: Sugerman, B. B Insects and other Arthropods from Kwajalein Atoll (Marshall Islands). Proceedings of the Hawaiian Entomological Society 21: Sugerman, B. B Additions to the list of insects and other arthropods from Kwajalein Atoll (Marshall Islands). Proceedings of the Hawaiian Entomological Society 23: Traub, R., C. L. Wisseman, & A. Farhang-Azad The ecology of murine typhus A critical review. Tropical Disease Bulletin 75: Webb L., M. Carl, D. C. Malloy, G. A. Dasch, & A. F. Azad Detection of murine typhus infection in fleas by using the polymerase chain reaction. Journal of Clinical Microbiology 28: WHO Dengue fever in the South Pacific Islands. Weekly. Epidemiology Record 11: 119.

8 Reeves et al.: Rickettsial pathogens in Kwajalein and Wake 113 Wilson, N Acarina: Mesostigmata: Dermanyssidae, Laelapidae, Spinturnicidae parasitic on vertebrates. Insects of Micronesia 3: Wilson, N. 1972a. Anoplura supplement. Insects of Micronesia 8: Wilson, N. 1972b. Notes on some Ctenocephalides from Micronesia. Proceedings of the Entomological Society of Washington 74: 184. Received 17 June 2011, revised 28 Sep. 2011

Rickettsial pathogens and arthropod vectors of medical and veterinary significance on Kwajalein Atoll and Wake Island

Micronesica 43(1): 107 113, 2012 Rickettsial pathogens and arthropod vectors of medical and veterinary significance on Kwajalein Atoll and Wake Island Will K. Reeves USAF School of Aerospace Medicine (USAFSAM/PHR)